Celiac disease, also called gluten-sensitive enteropathy, is a serious condition that affects an estimated 2 million people in the U.S. today. If you have celiac disease, eating gluten can severely harm your health, so sticking to a gluten-free diet is critical.
Here, we’ll answer some questions about celiac disease as well as explore what the research says about proper diet and foods you should avoid at all costs.
What Is Celiac Disease
Celiac disease is an autoimmune condition in which gluten triggers the body to attack the small intestine. These attacks cause damage to the villi of the small intestine which then prevents nutrients from being properly absorbed into the body.
Gluten, a protein found in grains including wheat, barley, and rye, is a common ingredient found in a number of foods. In fact, even personal products like toothpaste and supplements can contain gluten.
When someone with celiac consumes gluten—even the smallest amount—it can cause damage to the digestive system. This damage can have lasting effects on a person’s health, in some cases leading to malnutrition, anemia, and reproductive problems.
Is celiac an autoimmune disease?
Celiac is an autoimmune disease. In other words, it is a disease in which your body’s immune system attacks healthy cells by mistake. In people with celiac disease, this occurs when gluten is consumed and the body mounts an immune response that attacks the small intestine.
Is celiac disease genetic?
Yes, celiac disease is genetic meaning it is passed down through our parents. In fact, only people with one of two gene variants, DQ2 or DQ8, can develop the autoimmune condition. However, just because someone has one of these gene variants doesn’t mean they will develop celiac disease. It just means that a person can and is more likely to.
If a family member has celiac disease and you react poorly when you consume gluten, visit your doctor right away to learn if you have the disease and, if so, how to prevent further intestinal damage.
Can celiac disease kill you?
In some cases, celiac disease can lead to death. However, the disease itself does not progress, but rather it can lead to other conditions that can result in premature death, including cancer.
One study discovered that people with undiagnosed celiac disease have a significantly greater risk of death and that the prevalence of undiagnosed celiac disease in the U.S. has increased dramatically in recent decades.
However, with diagnosis and adherence to a gluten-free diet, this risk is highly preventable.
What is the difference between celiac disease and gluten intolerance?
The major difference between celiac disease and gluten intolerance is that gluten intolerance does not damage the small intestine to the extent that celiac disease does. Additionally, gluten intolerance can be triggered by infections, medication, or surgery.
However, it can be hard to tell if you have celiac disease or gluten intolerance as some of the symptoms are similar including:
- Abdominal pain
- Brain fog
Additionally, gluten intolerance is one of the most common food intolerances. In fact, an estimated 6% of the U.S. has gluten intolerance or non-celiac gluten sensitivity.
Ultimately, if you experience any of the above symptoms, it is important to talk to your doctor right away. They can order blood tests to determine if you have celiac disease which can prevent unnecessary health complications down the road.
What happens when a celiac eats gluten?
When a person with celiac disease eats gluten, their body creates an immune response attacking the small intestine. These attacks cause damage to the villi, which are small fingerlike projections that help the body absorb nutrients. Symptoms may include headaches, joint pain, fatigue, abdominal pain, diarrhea, bloating, or no symptoms at all.
However, while the symptoms may manifest differently, if a person with celiac disease continues to eat gluten it can have serious long-term health consequences.
How To Test For Celiac Disease
There are a couple of different ways to test for celiac disease.
Your doctor or a gastroenterologist can perform a blood test to check for associated antibodies. Although, this test is most accurate only if the patient is currently or has recently consumed gluten.
Genetic testing can also be revealing, but it can only rule out the possibility of the autoimmune disorder. In other words, if you do not have one of the two associated gene variants then you cannot have celiac disease – however, the presence of these variants doesn’t confirm that you have the disease.
An endoscopy is another option that is slightly more invasive although relatively painless. It involves sending a camera attached to a long thin tube through the digestive tract. This allows the doctor to take small biopsies of the small intestine which can then be used to confirm or rule out celiac.
If you think you may have celiac disease, discuss the options for testing with your doctor and find one that works best for you.
Can celiac disease cause weight gain?
Celiac disease can cause weight gain, but this typically occurs after beginning a gluten-free diet. Before being diagnosed with celiac disease, weight loss is more common. This is because intestinal damage can cause malabsorption of nutrients. After beginning a gluten-free diet, someone with celiac may slowly gain weight. This can be a positive sign that the intestine is healing and nutrient absorption is increasing.
However, continued weight gain can mean someone is eating an unhealthy gluten-free diet. Unfortunately, many gluten-free alternatives contain more carbohydrates, calories, fat, and sugar than gluten-containing processed foods. For these reasons, it’s extremely important to consult a dietician to maintain a healthy weight while on a gluten-free diet.
Celiac Disease Diet
Avoiding gluten is paramount to an effective celiac disease diet. Someone with celiac disease, while not being able to eat many grain products, can benefit from a healthy diet of fruits, vegetables, meat, and good-for-you fats, as well as gluten-free whole grains.
While there are many gluten-free alternatives to breads, pastas, crackers, and other wheat products available, processed versions can be full of sugar and other unhealthy ingredients. It is important to choose healthy alternatives such as whole or enriched gluten-free grains like quinoa, brown rice, wild rice, and buckwheat.
People with celiac disease are at risk of nutritional deficiencies, particularly in B vitamins, fiber, calcium, iron, magnesium, and zinc, but grains such as these can help promote adequate nutrition. Because celiac disease can result in nutritional deficiencies and consuming gluten has serious consequences for those with the disease, the Academy of Nutrition and Dietetics strongly recommends medical nutritional therapy on an ongoing basis. A dietician can test for nutritional deficiencies and recommend supplementation if necessary. Additionally, they can provide education regarding a gluten-free diet and when cross-contamination with gluten is possible.
With the right support and knowledge, following a celiac disease diet can enhance your quality of life and prevent negative long-term health consequences.
Can someone with celiac disease eat cheese?
Yes, someone with celiac disease can eat cheese. However, even though cheese is generally free from gluten, it is important to always check the ingredient label to be sure. You will want to make sure wheat is not listed as an ingredient, especially for processed shredded cheeses and spreads. An ingredient label must list whether or not the product contains wheat, so if it doesn’t then you are safe to eat!
Can someone with celiac disease eat oats?
People with celiac disease can eat oats. However, some oats you find at the store are made in facilities that also make wheat products, which means they may contain traces of gluten. When shopping for oats and oat products, ensure the label specifically states they are gluten-free.
Research suggests that consuming approximately ¼ cup of gluten-free oats per day can improve compliance with a gluten-free diet.
4 Foods To Avoid For Celiac Disease
Avoiding bread and bread products like pastries, sandwiches, and cakes that contain gluten is pretty straightforward. However, some foods and beverages that contain gluten can be tricky to spot. Here are a few foods to avoid for celiac disease that may not be obvious to someone new to a gluten-free diet.
Malt is a gluten-containing grain that is used in a variety of foods and beverages. These include milkshakes, malt vinegar, malt syrup, and malted milk. Because malt usually comes in a liquid form, many don’t realize it is actually a grain product that contains gluten and, thus, should be avoided for those with celiac disease. You’ll probably come into contact with malt the most when ordering a milkshake or fish & chips.
Panko breadcrumbs and many other products used to make fried foods or breaded meats contain gluten. Common examples you might see on a restaurant menu include chicken parmesan, battered fish, mozzarella sticks, and calamari, to name a few. Even french fries and potato chips may be cross-contaminated with gluten if the same fryer is used to fry them that is used to fry breaded foods. The best way to know if the food you order is safe from cross-contamination is to ask your server.
Most beer is made from grain, most commonly malted barley and wheat, which are gluten-containing grains. Beer is also not distilled, which is a process of making alcohol and vinegar that gluten particles can’t survive. Although most popular beers contain gluten and should be avoided, many gluten-free beers are available, and most other alcoholic beverages are naturally gluten-free.
Many sauces, marinades, and dressings are sneaky sources of gluten as they can contain malt vinegar, soy sauce, or flour. These gluten agents are often used as flavorings and thickening agents. So, always read the ingredient label to ensure a packaged sauce or dressing is free from these ingredients. Eating out can be tricky, but many restaurants are now aware of and accommodating of food allergies and celiac disease. Just be sure to tell your server if you have celiac disease so they can point out menu items that contain gluten.
Treatment for Celiac Disease
Currently, the only treatment for celiac disease is to follow a gluten-free diet. People who follow a celiac disease diet and avoid gluten completely can eliminate symptoms and, if caught early enough, prevent the onset of additional disease.
Research supports that life-long adherence to a gluten-free diet improves outcomes related to bone density, anemia, gastrointestinal and neurological symptoms, pregnancy outcomes, and quality of life amongst celiacs. And while gluten can be prevalent in many packaged foods and restaurant dishes, when you’re aware of the foods to avoid with celiac disease, you can manage the diet more easily.
Can celiac disease go away?
Unfortunately, celiac disease does not go away. However, with adherence to a strict gluten-free diet, the intestine can heal, and further damage can be prevented. To prevent future symptoms, avoid gluten-containing foods and enlist the help of a medical team, including your doctor and dietician.